Counting Melanoma Mitoses
Mitogenicity an important prognostic factor in patients with thin primary cutaneous melanoma. In the American Joint Commission on Cancer (AJCC) seventh edition melanoma staging system, mitoses, ulceration and tumor thickness form the foundation for stagin
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Counting Melanoma Mitoses
Mitogenicity is an important prognostic factor in patients with thin primary cutaneous melanoma. In the American Joint Commission on Cancer (AJCC) seventh edition melanoma staging system, mitoses, ulceration and tumor thickness form the foundation for staging thin primary cutaneous melanoma. Studies demonstrating the prognostic value of mitogenicity used the “hot spot” technique for quantitation. The AJCC Melanoma Staging Committee recommends the use of the hot spot method with reports containing the number of mitoses counted in a square millimeter. This is accomplished by examination of routine hematoxylin and eosin (H&E) stained tissue sections; exhaustive tissue sectioning is not necessary. • Use the “hot spot” method:
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– Scan the H&E stained tissue section for the region of the dermal tumor with the greatest number of mitotic figures → this is the starting point of the count. Count the next consecutive high power fields till one square millimeter has been evaluated. (Each microscope is different; 1 mm squared is four fields at 40× in some microscopes.) • Report the number of mitotic figures counted per mm2 • If only one mitosis is found in any field, report this as 1 mitosis/mm2 – Do NOT report as
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